PDF(Pubmed)
Abstract：
BACKGROUND: Asthma is a leading cause of children\'s hospitalizations, emergency department visits, and missed school days. Our school-based asthma intervention has reduced asthma exacerbations for children experiencing health disparities in the Denver Metropolitan Area, due partly to addressing care coordination for asthma and social determinants of health (SDOH), such as access to healthcare and medications. Limited dissemination of school-based asthma programs has occurred in other metropolitan and rural areas of Colorado. We formed and engaged community advisory boards in socioeconomically diverse regions of Colorado to develop two implementation strategy packages for delivering our school-based asthma intervention - now termed \"Better Asthma Control for Kids (BACK)\" - with tailoring to regional priorities, needs and resources.
METHODS: In this proposed type 2 hybrid implementation-effectiveness trial, where the primary goal is equitable reach to families to reduce asthma disparities, we will compare two different packages of implementation strategies to deliver BACK across four Colorado regions. The two implementation packages to be compared are: 1) standard set of implementation strategies including Tailor and Adapt to context, Facilitation and Training termed, BACK-Standard (BACK-S); 2) BACK-S plus an enhanced implementation strategy, that incorporates network weaving with community partners and consumer engagement with school families, termed BACK-Enhanced (BACK-E). Our evaluation will be guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, including its Pragmatic Robust Implementation Sustainability Model (PRISM) determinants of implementation outcomes. Our central hypothesis is that our BACK-E implementation strategy will have significantly greater reach to eligible children/families than BACK-S (primary outcome) and that both BACK-E and BACK-S groups will have significantly reduced asthma exacerbation rates (\"attacks\") and improved asthma control as compared to usual care.
CONCLUSIONS: We expect both the BACK-S and BACK-E strategy packages will accelerate dissemination of our BACK program across the state - the comparative impact of BACK-S vs. BACK-E on reach and other RE-AIM outcomes may inform strategy selection for scaling BACK and other effective school-based programs to address chronic illness disparities.
BACKGROUND: Clinicaltrials.gov identifier: NCT06003569, registered on August 22, 2023, https://classic.
RESULTS: gov/ct2/show/NCT06003569 .
METHODS: In this proposed type 2 hybrid implementation-effectiveness trial, where the primary goal is equitable reach to families to reduce asthma disparities, we will compare two different packages of implementation strategies to deliver BACK across four Colorado regions. The two implementation packages to be compared are: 1) standard set of implementation strategies including Tailor and Adapt to context, Facilitation and Training termed, BACK-Standard (BACK-S); 2) BACK-S plus an enhanced implementation strategy, that incorporates network weaving with community partners and consumer engagement with school families, termed BACK-Enhanced (BACK-E). Our evaluation will be guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, including its Pragmatic Robust Implementation Sustainability Model (PRISM) determinants of implementation outcomes. Our central hypothesis is that our BACK-E implementation strategy will have significantly greater reach to eligible children/families than BACK-S (primary outcome) and that both BACK-E and BACK-S groups will have significantly reduced asthma exacerbation rates (\"attacks\") and improved asthma control as compared to usual care.
CONCLUSIONS: We expect both the BACK-S and BACK-E strategy packages will accelerate dissemination of our BACK program across the state - the comparative impact of BACK-S vs. BACK-E on reach and other RE-AIM outcomes may inform strategy selection for scaling BACK and other effective school-based programs to address chronic illness disparities.
BACKGROUND: Clinicaltrials.gov identifier: NCT06003569, registered on August 22, 2023, https://classic.
RESULTS: gov/ct2/show/NCT06003569 .
摘要：
背景：哮喘是儿童住院的主要原因，急诊部门的访问，错过了上学的日子。我们以学校为基础的哮喘干预措施减少了丹佛都会区健康差异儿童的哮喘恶化，部分原因是解决哮喘和健康社会决定因素(SDOH)的护理协调问题，例如获得医疗保健和药物。在科罗拉多州的其他大都市和农村地区，基于学校的哮喘计划的传播有限。我们在科罗拉多州社会经济多元化地区成立并参与社区咨询委员会，以制定两个实施策略包，以提供我们基于学校的哮喘干预措施-现在称为“更好的儿童哮喘控制（BACK）”-根据区域优先事项进行调整，需求和资源。
方法：在这项拟议的2型混合实施-有效性试验中，主要目标是公平接触家庭以减少哮喘差异，我们将比较两个不同的一揽子实施策略，以在科罗拉多州的四个地区提供回报。要比较的两个实施包是：1）实施策略的标准集，包括裁缝和适应上下文，便利和培训称为，BACK-标准（BACK-S）；2）BACK-S加上增强的实施策略，包括与社区合作伙伴的网络编织和与学校家庭的消费者参与，称为BACK-增强(BACK-E)。我们的评估将由Reach指导，有效性,收养,实施,和维护(RE-AIM)框架，包括其务实稳健的实施可持续性模型(PRISM)实施结果的决定因素。我们的中心假设是，与BACK-S（主要结果）相比，我们的BACK-E实施策略对符合条件的儿童/家庭的影响要大得多，并且与常规护理相比，BACK-E和BACK-S组将显着降低哮喘加重率（“发作”）并改善哮喘控制。
结论：我们预计BACK-S和BACK-E战略包将加速我们的BACK计划在全州的传播-BACK-S与BACK-S的比较影响BACK-E对可达性和其他RE-AIM结果的选择可能会为扩展BACK和其他有效的基于学校的计划提供策略选择，以解决慢性病差异。
背景：Clinicaltrials.gov标识符：NCT06003569，于2023年8月22日注册，https：//classic。
结果：gov/ct2/show/NCT06003569。
方法：在这项拟议的2型混合实施-有效性试验中，主要目标是公平接触家庭以减少哮喘差异，我们将比较两个不同的一揽子实施策略，以在科罗拉多州的四个地区提供回报。要比较的两个实施包是：1）实施策略的标准集，包括裁缝和适应上下文，便利和培训称为，BACK-标准（BACK-S）；2）BACK-S加上增强的实施策略，包括与社区合作伙伴的网络编织和与学校家庭的消费者参与，称为BACK-增强(BACK-E)。我们的评估将由Reach指导，有效性,收养,实施,和维护(RE-AIM)框架，包括其务实稳健的实施可持续性模型(PRISM)实施结果的决定因素。我们的中心假设是，与BACK-S（主要结果）相比，我们的BACK-E实施策略对符合条件的儿童/家庭的影响要大得多，并且与常规护理相比，BACK-E和BACK-S组将显着降低哮喘加重率（“发作”）并改善哮喘控制。
结论：我们预计BACK-S和BACK-E战略包将加速我们的BACK计划在全州的传播-BACK-S与BACK-S的比较影响BACK-E对可达性和其他RE-AIM结果的选择可能会为扩展BACK和其他有效的基于学校的计划提供策略选择，以解决慢性病差异。
背景：Clinicaltrials.gov标识符：NCT06003569，于2023年8月22日注册，https：//classic。
结果：gov/ct2/show/NCT06003569。
